新生儿心胸外科术后血液降钙素原变化及其临床意义  

Change and Clinical Significance of Blood Procalcitonin in Newborns after Cardiothoracic Surgery

作　　者：陈竹雨 CHEN Zhu-yu(Clinical Laboratory,the First Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China)

机构地区：[1]张家口市第一医院检验科,河北张家口075000

出　　处：《河北北方学院学报（自然科学版）》2019年第4期11-13,17,共4页Journal of Hebei North University:Natural Science Edition

基　　金：张家口市科学技术研究与发展计划项目(No.1521029D)

摘　　要：目的检测行心胸外科手术(cardiothoracic surgery,CS)的新生儿术后血液降钙素原(procalcitonin,PCT)变化,探讨PCT在新生儿CS术后败血症中的诊断意义。方法选取46例行CS术治疗的新生儿纳入本研究,分别于术前2 h、术后0、12、24、48、72 h采集受试者血液样本,检测PCT和C反应蛋白(C-reactive protein,CRP)水平,并比较心肺分流术(cardiopulmonary bypass,CPB)及败血症合并与否对新生儿PCT和CRP的影响。结果 46例新生儿中,31例行CPB,3例术后发生败血症(6.67%)。不同时间点CPB组与非CPB组相比PCT无明显改变,但2组CRP在术后48、72 h存在显著差异(P=0.029,P=0.018);与未发生败血症的患儿相比,发生败血症的患儿术后48、72 h PCT显著升高,但CRP变化不明显。结论 PCT有助于临床医师有效区分新生儿CS术后单纯全身炎症反应综合征及败血症,有望成为确定新生儿CS术后是否合并败血症的良好生物学标志物。Objective To detect change of blood procalcitonin(PCT)in newborns after cardiothoracic surgery(CS),and to explore the diagnostic significance of PCT in sepsis after CS. Methods 46 newborns undergoing CS were enrolled in this study.Blood samples were collected at 2 h before operation and 0,12,24,48,72 h after operation.Levels of PCT and C-reactive protein(CRP)were measured.The effects of cardiopulmonary bypass(CPB)and sepsis on PCT and CRP in newborns were compared. Results In 46 newborns,31 cases received CPB and 3 cases had sepsis(6.67%).There was no significant difference in PCT between CPB group and non-CPB group at different time points,but there was significant difference in CRP between two groups at 48 h and 72 h after operation( P =0.029, P =0.018).Compared with newborns without sepsis,PCT in newborns with sepsis increased significantly at 48 h and 72 h after operation,but CRP of two groups was not significantly different. Conclusion PCT is helpful for clinicians to differentiate the simple systemic inflammatory response syndrome(SIRS)and sepsis in newborns after CS,and it is expected to be a good biomarker for determining whether newborns undergoing CS were complicated with sepsis or not.

关 键 词：降钙素原 新生儿 败血症 心胸外科手术 心肺分流术 

分 类 号：R722.13[医药卫生—儿科]